Clinical Observation Of Female Bladder Neck Obstruction With Detrusor Underactivity After The Surgical Treatment

Objective:Currently, there is no standardized diagnosis and treatment methods for female bladder neck obstruction, especially for these patients with female detrusor underactivity. Now transurethral bladder neck incision, bladder puncture colostomy surgery and conservative treatment method have been applied in such patients. But the effect is not sure. Based on line of bladder neck dissection patients and patients with conservative treatment efficacy observation, we research the value and the necessity of this surgery patients.Methods:Choose55cases of female patients who take examination of urodynamics that prompts urinary bladder detrusor muscle damaged in:Pdet@Qmax<20cmH20or urinate with abdominal pressure obviously, and Qmax<12ml/s. And cystourethroscope or ultrasonic that have no presentation of bladder neck obstruction. Then eliminating nervous system disease history and history of pelvic organ prolapse, pelvic surgery, routine urine without urinary tract infection, etc, to confirm the diagnosis of primary bladder neck obstruction. Then according to the patient wishes,35underwent transurethral bladder neck dissection mouth+alpha blockers,20cases for alpha blockers conservative medical treatment. After three months’medical treatment, according to the quality of life scores (QOL)、Qmax and PVR, review that micturition symptoms improve or not.Results:1.According to the average operation time, surgical blood loss, postoperative hospitalization days and postoperative incontinence cases such as the safety index, suggests transurethral bladder neck dissection and alpha blockers are safe and reliable treatment method;2. Treated by urethra bladder neck dissection (+bladder puncture on pubic colostomy)+alpha blockers group of patients:the total effective basic at about77.1%, and for pure alpha blockers patients’total less than35%efficient.3. According to Qmax before and after surgery, the patients with surgical treatment is better than these with alpha blockers.Conclusion:1Transurethral bladder neck dissection and alpha blockers are mouth female bladder neck obstruction merge detrusor weak safety treatment2Combined use of transurethral bladder neck dissection+mouth alpha blockers in micturition symptoms and improve patients quality of life better than drugs.